Clinical importance of thrombocytopenia in patients with acute coronary syndromes: a systematic review and meta-analysis
Thrombocytopenia (TP) is common in hospitalized patients. In the context of acute coronary syndromes (ACS), TP has been linked to adverse clinical outcomes. We present a systematic review and meta-analysis of the evidence on the clinical importance of preexisting and in-hospital acquired TP in the c...
| Main Authors: | , , , , |
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| Format: | Article |
| Language: | English |
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Taylor & Francis Group
2019-10-01
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| Series: | Platelets |
| Subjects: | |
| Online Access: | http://dx.doi.org/10.1080/09537104.2018.1528348 |
| _version_ | 1797684225841823744 |
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| author | Vanessa Discepola Mireille E. Schnitzer E. Marc Jolicoeur Guy Rousseau Marie Lordkipanidzé |
| author_facet | Vanessa Discepola Mireille E. Schnitzer E. Marc Jolicoeur Guy Rousseau Marie Lordkipanidzé |
| author_sort | Vanessa Discepola |
| collection | DOAJ |
| description | Thrombocytopenia (TP) is common in hospitalized patients. In the context of acute coronary syndromes (ACS), TP has been linked to adverse clinical outcomes. We present a systematic review and meta-analysis of the evidence on the clinical importance of preexisting and in-hospital acquired TP in the context of ACS. Specifically, we address (a) the prevalence and associated factors with TP in the context of ACS; and (b) the association between TP and all-cause mortality, major adverse cardiovascular events (MACEs), and major bleeding. We conducted systematic literature searches in MEDLINE and Web of Science. For the meta-analysis, we fit linear mixed models with a random study-specific intercept for the aggregate outcomes. A total of 16 studies and 190 915 patients were included in this study. Of these patients, 8.8% ± 1.2% presented with preexisting TP while 5.8% ± 1.0% developed TP after hospital admission. Preexisting TP was not statistically significantly associated with adverse outcomes. Acquired TP was associated with greater risk of all-cause mortality (risk difference [RD]: 4.3%; 95% confidence interval [CI]: 2–6%; p = 0.04), MACE (RD: 8.5%; 95% CI: 1–16.0%; p = 0.037), and major bleeding (RD: 11.9%; 95% CI: 5–19%; p = 0.005). In conclusion, TP is a prevalent condition in patients admitted for an ACS and identifies a high-risk patient population more likely to experience ischemic and bleeding complications, as well as higher mortality. |
| first_indexed | 2024-03-12T00:27:31Z |
| format | Article |
| id | doaj.art-cfa6781aa40949b6818f4c552b8653d6 |
| institution | Directory Open Access Journal |
| issn | 0953-7104 1369-1635 |
| language | English |
| last_indexed | 2024-03-12T00:27:31Z |
| publishDate | 2019-10-01 |
| publisher | Taylor & Francis Group |
| record_format | Article |
| series | Platelets |
| spelling | doaj.art-cfa6781aa40949b6818f4c552b8653d62023-09-15T10:32:00ZengTaylor & Francis GroupPlatelets0953-71041369-16352019-10-0130781782710.1080/09537104.2018.15283481528348Clinical importance of thrombocytopenia in patients with acute coronary syndromes: a systematic review and meta-analysisVanessa Discepola0Mireille E. Schnitzer1E. Marc Jolicoeur2Guy Rousseau3Marie Lordkipanidzé4Université de MontréalUniversité de MontréalUniversité de MontréalUniversité de MontréalResearch Center, Montreal Heart InstituteThrombocytopenia (TP) is common in hospitalized patients. In the context of acute coronary syndromes (ACS), TP has been linked to adverse clinical outcomes. We present a systematic review and meta-analysis of the evidence on the clinical importance of preexisting and in-hospital acquired TP in the context of ACS. Specifically, we address (a) the prevalence and associated factors with TP in the context of ACS; and (b) the association between TP and all-cause mortality, major adverse cardiovascular events (MACEs), and major bleeding. We conducted systematic literature searches in MEDLINE and Web of Science. For the meta-analysis, we fit linear mixed models with a random study-specific intercept for the aggregate outcomes. A total of 16 studies and 190 915 patients were included in this study. Of these patients, 8.8% ± 1.2% presented with preexisting TP while 5.8% ± 1.0% developed TP after hospital admission. Preexisting TP was not statistically significantly associated with adverse outcomes. Acquired TP was associated with greater risk of all-cause mortality (risk difference [RD]: 4.3%; 95% confidence interval [CI]: 2–6%; p = 0.04), MACE (RD: 8.5%; 95% CI: 1–16.0%; p = 0.037), and major bleeding (RD: 11.9%; 95% CI: 5–19%; p = 0.005). In conclusion, TP is a prevalent condition in patients admitted for an ACS and identifies a high-risk patient population more likely to experience ischemic and bleeding complications, as well as higher mortality.http://dx.doi.org/10.1080/09537104.2018.1528348acute coronary syndromebleedingischemiamajor adverse cardiac eventsmortalitythrombocytopenia |
| spellingShingle | Vanessa Discepola Mireille E. Schnitzer E. Marc Jolicoeur Guy Rousseau Marie Lordkipanidzé Clinical importance of thrombocytopenia in patients with acute coronary syndromes: a systematic review and meta-analysis Platelets acute coronary syndrome bleeding ischemia major adverse cardiac events mortality thrombocytopenia |
| title | Clinical importance of thrombocytopenia in patients with acute coronary syndromes: a systematic review and meta-analysis |
| title_full | Clinical importance of thrombocytopenia in patients with acute coronary syndromes: a systematic review and meta-analysis |
| title_fullStr | Clinical importance of thrombocytopenia in patients with acute coronary syndromes: a systematic review and meta-analysis |
| title_full_unstemmed | Clinical importance of thrombocytopenia in patients with acute coronary syndromes: a systematic review and meta-analysis |
| title_short | Clinical importance of thrombocytopenia in patients with acute coronary syndromes: a systematic review and meta-analysis |
| title_sort | clinical importance of thrombocytopenia in patients with acute coronary syndromes a systematic review and meta analysis |
| topic | acute coronary syndrome bleeding ischemia major adverse cardiac events mortality thrombocytopenia |
| url | http://dx.doi.org/10.1080/09537104.2018.1528348 |
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